# Translation, cross-cultural adaptation into Brazilian Portuguese and electronic migration of the WERF EPHect endometriosis patient questionnaire

## TL;DR

This study translated and adapted a patient questionnaire for endometriosis into Brazilian Portuguese and converted it into an electronic format, finding that the electronic version was faster and more accessible.

## Contribution

The novel contribution is the cross-cultural adaptation and electronic migration of the WERF EPHect EPQ-S questionnaire into Brazilian Portuguese using REDCap.

## Key findings

- The electronic version of the questionnaire had a significantly shorter completion time compared to the paper version.
- Both paper and electronic versions showed similar rates of missing data for key questions.
- The electronic version was more accessible and preferred by participants, especially those with lower education levels.

## Abstract

To translate and cross-culturally adapt the standard version of the WERF EPHect EPQ into Brazilian Portuguese and migrate it to an electronic version using REDCap.

The study included 120 women aged 18–50 years, with half completing the paper version and half the electronic version. The sample comprised 80 individuals with chronic pelvic pain (CPP), including 60 with endometriosis, recruited from a tertiary referral centre, and 40 women from a primary healthcare unit with no diagnosis of CPP or endometriosis. Illiterate or cognitively impaired individuals were excluded. The electronic migration was implemented in REDCap.

The Brazilian Portuguese EPQ-S demonstrated linguistic accuracy and cultural equivalence to the original English version. The paper version consisted of 35 pages, and 86.7% of respondents commented on its length. Despite this, it was well-received, although minor difficulties were observed among participants with lower education levels. The electronic version provided a more accessible experience, with a significantly shorter completion time (52.1 ± 13.2 minutes) compared to the paper version (70.9 ± 21.4 minutes). Both formats exhibited similar rates of missing data for questions related to symptoms and contraceptive use.

This study successfully translated, adapted, and migrated the WERF EPHect EPQ-S into Brazilian Portuguese using REDCap. The findings underscore the linguistic and cultural challenges of such adaptations and highlight the electronic version's advantages in accessibility, efficiency, and participant satisfaction. This research supports the development of cross-cultural assessment tools for endometriosis research and healthcare delivery.